Summaries of health policy coverage from major news organizations

The Philadelphia Fire Department's efforts to protect firefighters from contracting hepatitis C "fall far short" of government and industry standards on protecting workers from the bloodborne disease, the Philadelphia Inquirer reports in a special profile of the hepatitis C epidemic among city rescue workers. About 200 of the city's 4,400 retired and active firefighters and paramedics are infected with hepatitis C. An Inquirer analysis of federal standards and seven other fire departments across the country "exposed severe shortcomings" in how the city fire department educates and trains workers about the disease and its prevention. The review found that the department is "less aggressive in training and monitoring, handling contaminated clothing and equipment and making tools for infection control -- such as goggles and disinfectant -- readily available" for firefighters. In seven of the eight cities examined, only Philadelphia does not require firefighters to undergo annual training or drills on infection control. While Houston paramedics who come in contact with blood have their uniforms and rescue gear decontaminated by an industrial cleaning service, Philadelphia rescue workers "take their bloodied uniforms home to wash," the Inquirer reports. In addition, Philadelphia rescue workers who receive needlesticks are sent to area emergency rooms, where they must wait, sometimes for several hours, to see a doctor. In contrast, the New York City Fire Department sends a doctor to exposed workers' homes to administer medication to prevent HIV infection. Philadelphia is the only city in the analysis that does not have a designated infection control officer and was one of the two cities that do not provide separate disinfecting facilities for cleaning emergency medical equipment. Fire Commissioner Harold Harston "dismissed" the allegation that the fire department "lagged" in infection control. "Fact is, I've done everything reasonably possible, given resources, to react to these things in an appropriate way. No one has not been properly served," he said. Harston added that all city firefighters have access to infection control equipment, such as gloves, goggles, masks and disinfectant.

Progress in Training and Treatment
Beginning this year, all firefighters and paramedics will receive annual training in infection control, according to Ron Augustyn, a human resources manager in the fire department. Augustyn added that the department is currently revising its infection control guidelines to conform with CDC and OSHA standards. Harston said of the department's changes, "We're going to have to do some things differently." The firefighters' union has been instrumental in bringing about some of these changes, the Inquirer reports. The union recently was awarded more funding for medical costs related to hepatitis C, and infected firefighters also were given additional sick time. However, the city has not conceded on all points on the hepatitis C issue, the Inquirer says. Philadelphia "has fought firefighters' claims" that hepatitis C is a work-related illness, and the city has "tried to deny workers' compensation" to infected firefighters, citing the high cost of providing medical care as the reason. Six firefighters who contracted the disease have filed claims against the city for workers' compensation, but the city "is fighting" the demands. In the Pennsylvania Legislature, however, "momentum is building" to classify hepatitis C as a work-related disease (Lin, Philadelphia Inquirer, 2/4). In October, a bill introduced in the Legislature aimed to change workers' compensation laws to make hepatitis C an occupational disease for rescue workers (Kaiser Daily HIV/AIDS Report, 10/24/2000).

Personal Profiles
Sunday's Inquirer also featured a collection of articles focusing on city rescue workers who have occupationally acquired hepatitis C. One article focused on Fred Kozachyn, a paramedic who contracted the disease when he was splattered with the blood of an infected woman he was rescuing from a car wreck. Another article described former paramedic Joseph Montague's battle against the "stigma," "fear" and "shame" of the disease. The Inquirer also profiled firefighter Ed McCall, who contracted hepatitis C after coming in contact with an infected woman in labor (Philadelphia Inquirer, 2/4).

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